| Diagnostic and Therapeutic Impacts of Hemodynamic Data from Pulmonary Artery Catheterization in Critically Ill Patients. |
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Eun Chi Bang, Shin Ok Koh, Soon Ho Nam, Jong Rae Kim, Hye Won Cho |
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Department of Anesthesiology, Yonsei Universiy, College of Medicine, Seoul, Korea. |
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| Abstract |
BACKGROUND
The hemodynamic status of critically ill patients is poorly predicted from clinical examination and chest x-ray findings, so equipments such as pulmonary artery catheter are needed for monitoring of hemodynamics. The authors undertook this study to evaluate physician's accuracy in predicting hemodynamic profiles, rates of therapeutic change resulting from catheterization and to compare the outcomes with or without therapeutic changes.
METHODS
Pulmonary artery catheters were inserted in 19 critically ill patients. The physicians accuracy of predicting the hemodynamic profile, the rate of therapeutic changes by monitoring actual hemodynamic profiles were calculated and compared to the outcome between the patients with and without therapeutic change, RESULTS: Hemodynamic profiles were correctly predicted in 63% of all cases. Hemodynamic data from pulmonary artery catheter made the therapeutic plan changed in 53% of all cases. The cardiac index and left ventricular stroke work index were improved and the mortality rate was lower in patients with therapeutic changes, but there were no significant statistical differences between the patients with and without therapeutic changes. Complications occurred in 6 cases but had no effect on patient' s outcome.
CONCLUSIONS
Hemodynamic data from a pulmonary artery catheter could lead to a more accurate diagnosis and therapeutic changes. |
| Key Words:
Equipment; cathetens; pulmonary arterial; Monitoring; hemodynamics; Outcome; mortality |
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